Organization
WARREN C. SORDILL DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WARREN C. SORDILL DMD (OWNER)
(973) 992-4750
Entity
Organization
Contact information
Practice address
209 S LIVINGSTON AVE, SUITE 2, LIVINGSTON, NJ 07039-4044
(973) 992-4750
(973) 992-5262
Mailing address
209 S LIVINGSTON AVE, SUITE 2, LIVINGSTON, NJ 07039-4044
(973) 992-4750
(973) 992-5262
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
512859
MEDICARE PROVIDER # 512859
NJ
Enumeration date
04/16/2012
Last updated
04/16/2012
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